Screening Study On Arrhythmia With SnapECG Focusing On Atrial Fibrillation In A Nanjing Community

BackgroundArrhythmias are the most common cardiovascular disorders and are frequently responsible of sudden death.AF is of a major concern as it is the most encountered arrhythmia.In addition it is a major risk factor for stroke,heart failure and sudden death and becomes more prevalent as the population ages.ObjectivesThe present research aimed to investigate arrhythmias focusing on AF detection rate and associated risk factors in a cohort aged?50 years old from PUKOU community,and to examine the accuracy of the new wireless SnapECG device in diagnosing arrhythmias.In the second part a comprehensive synthesis and review on community-based studies on AF prevalence was carried out to report a pooled prevalence of AF among population and to report the prevalence of AF among high-risk subgroups.MethodsWe determined the prevalence of arrhythmias and the distribution of risk factors among individuals participating in our study.To this end,we used interviews to collect data on past medical history,arrhythmias risk factors.12-lead ECG tracings were obtained for all 426participants aged between 50 and 92 years.SnapECG recordings were obtained in 46%of the participants.For the meta-analysis,a methodical literature search was performed in Pubmed database until the30^th of November 2017.Screening studies performed in a population or community-based focusing only on atrial fibrillation using a non-invasive device was considered for inclusion.ResultsThere were 426 participants in our study with an average age of 71 years.71.1%were female.In the 426 participants,16.4%were newly diagnosed with arrhythmias and 1.2%among them had AF.AF was found to be more common in older males?80.6±7.8?compared to persons in sinus rhythm or patients with other types of arrhythmias.A personal history of coronary heart disease was recorded in 8.2%of participants.Hypertension was previously diagnosed in 14.3%,diabetes and a history of stroke or TIA were reported by 14.6%and 8.0%of participants respectively.No history of obesity or hyperlipidemia was documented in the sample.SnapECG device recorded a sensitivity of 43.0%,specificity of 80.5%,PPV of 21.0%and a NPV of 87.0%.The area under the curve of the ROC was 0.67 and the kappa value between the observed cases and the expected cases was 0.16?P=0.79?.Nine studies were identified to be eligible for the meta-analysis.An overall prevalence of atrial fibrillation was 3.0%?95%CI=2%-5%?.The pooled prevalence in the high-risk subgroups was5.0%?95%CI=4%-6%?.AF prevalence among people with history of stroke or transient ischemic attack was 7.0%?95%CI=2%-12%?;5%?95%CI=3%-8%?in the diabetics;4.0%?95%CI=2%-6%?in the hypertensives and 4.0%?95%CI=2%-7%?in the smokers.ConclusionIn PUKOU community,AF is more prevalent in elderly males and is associated with smoking and coronary heart disease?P?0.05?.SnapECG exhibited a good performance in detecting accurately individuals without arrhythmias.Further researches on SnapECG with more than one recording are warranted.There is no doubt that AF prevalence is increasing therefore,screening should be intensified in people aged 65 years and above and individuals with additional risk factors like hypertension,diabetes and vascular diseases.